Robert Keith1 (April 28, p 1697) suggests that the INFANT trial2 is flawed by design. Previous reports3,4 suggested that a key element in substandard intrapartum care is the failure of clinicians to recognise an abnormal fetal heart-rate pattern, so the trial was set up to investigate whether decision support that detects and highlights abnormality of the fetal heart rate could improve outcomes. We compared decision support with no decision support. All other aspects of care were kept constant, including the use of the Guardian platform, which is the electronic data collection system in which the decision-support software operates.